Effect of Blue Light and Photosensitizers on Cutibacterium acnes on Shoulder Periprosthetic Joint Infection Isolates

Abstract. Introduction: Cutibacterium acnes is gaining recognition as a leading pathogen after orthopaedic shoulder procedures. Photodynamic therapy, a combination of light and a photosensitizer, has demonstrated antimicrobial activity against C. acnes in the treatment of acne vulgaris. We sought to evaluate the effect of photodynamic therapy using blue light and photosensitizers on C. acnes isolates from shoulder prosthetic joint infections.Methods: C. acnes strains isolated from 19 patients with shoulder PJI were exposed to blue light alone (415 nm) or in combination with photosensitizers (fluorescein, riboflavin and demeclocycline). C. acnes strains were divided into 4 categories: Highly Sensitive (HS), Sensitive (S), Weakly Sensitive (WS), Resistant to blue light.Results: 13 of 19 C. acnes strains (68%) were S or HS to blue light alone. Of these 19 strains tested, 11 were tested with blue light and fluorescein or blue light plus riboflavin. Fluorescein (1 µg/mL) enhanced the effect of blue light in 6 of 11 strains (55%). Blue light plus riboflavin (10 µg/mL) resulted enhanced killing in 3 of 11 strains (27%), but produced a paradoxical photoprotective effect in 4 of 11 strains (36%), resulting in a net decrease compared to blue light alone. Demeclocycline, however, enhanced the effect of blue light in 16 of 17 strains (94 %).Conclusions: Blue light with the addition of photosensitizers killed C. acnes from periprosthetic shoulder infections in vitro, with demeclocycline having the most pronounced effect.

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386. Blue Light Reduces Cutibacterium (Propionibacterium) Acnes Bacterial Burden: Orthopedic Shoulder Infection Prevention Strategy?

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.459 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S199-S200

Author(s):

Swati Bhargava ◽

Kathleen Boyle ◽

Sara Diletti ◽

Scott Nodzo ◽

John Crane ◽

...

Keyword(s):

Blue Light ◽

Limit Of Detection ◽

Acne Vulgaris ◽

Joint Infection ◽

Bacterial Burden ◽

Cutibacterium Acnes ◽

Sterile Normal Saline ◽

Vitro Model ◽

Shoulder Infection

Abstract Background Cutibacterium acnes (C. acnes) is a common shoulder periprosthetic joint infection (PJI). Blue light (BL) is effectively used in the dermatologic clinical setting against acne vulgaris caused by C. acnes. Photodynamic therapy (PDT) is the use of light source and photosensitizer (PS) to enhance antimicrobial activity. We studied the effect of PDT using BL and PS in vitro on shoulder PJI isolates of C. acnes. Methods 19 strains were grown in thioglycollate medium and diluted in sterile normal saline (NS) to a turbidity of 0.5 McFarland standard; OD600 of 0.1 to 0.15. 250 µL with PS added were placed in 96-well plates at 37ºC, exposed to BL (415 nm) placed 1 cm above for 0 to 60 minutes at 15-minute intervals. Susceptibility to BL alone, and BL with PSs such as riboflavin (R, Vit B2), fluorescein (F) or demeclocycline (tetracycline antibiotic, “D”) were studied. After serial 10-fold dilution with NS, 3 µL of each well were spotted onto Brucella Blood Agar plates and incubated anaerobically for 48 hours. Eradication was defined as below the limit of detection. Definitions include Sensitive (S) if 3-log decrease in bacterial density or eradication at any time point, Weakly Sensitive (WS) with 1- to 3-log decrease and Resistant (R) with no decrease. Results Based on BL alone, (n = 19). 68% strains were S, 32% were resistant. BL+ R (10 μg/mL) effect in 25% (n = 3) and exerted a protective effect against 33% (n = 4). BL+ F (1 μg/mL) potentiated in 67%. BL+ D (0.1–1.5 μg/mL) in 83% of strains tested. The most resistant strain was eradicated using BL + D at an increased concentration of demeclocycline (2.5 μg/mL). Conclusion F and D enhanced the potential for eradication compared with BL exposure alone. R was a photo-protectant to BL for select strains. Prior studies have hypothesized endogenous intracellular porphyrins excited by BL causing energy transfer and production of highly cytotoxic reactive oxygen species causing bacterial death. Future clinical research evaluating the use of preoperative PS and surgical site exposure to BL as a preventative PJI strategy are needed. Our research shows that BL with the addition of PS significantly reduces the bacterial burden of clinically relevant PJI shoulder isolates of C. acnes in an in vitro model. Disclosures All authors: No reported disclosures.

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Novel Topical Application of a Postbiotic, LactoSporin®, in Mild to Moderate Acne: A Randomized, Comparative Clinical Study to Evaluate its Efficacy, Tolerability and Safety

Cosmetics ◽

10.3390/cosmetics7030070 ◽

2020 ◽

Vol 7 (3) ◽

pp. 70 ◽

Cited By ~ 2

Author(s):

Muhammed Majeed ◽

Shaheen Majeed ◽

Kalyanam Nagabhushanam ◽

Lakshmi Mundkur ◽

H. R. Rajalakshmi ◽

...

Keyword(s):

Antimicrobial Activity ◽

Benzoyl Peroxide ◽

Pathogenic Bacteria ◽

Reductase Activity ◽

Acne Vulgaris ◽

Visual Assessment ◽

Open Label ◽

Cutibacterium Acnes ◽

Common Skin

Acne vulgaris is a common skin disorder of pilosebaceous units. The therapy for mild-to-moderate acne includes topical antibiotics, benzoyl peroxide and retinoids. In this open-label, randomized monocentric study, we compared the efficacy of LactoSporin® 2% w/w cream with benzoyl peroxide in 64 male and female subjects with mild-to-moderate acne for three weeks. The efficacy parameters were evaluated based on the dermatologist visual assessment and instrumental measurements using Sebumeter® MPA580, Antera 3DTM and VISIA CR 2.2 and subject self-assessment questionnaires. Adverse events were recorded throughout the study period. In order to understand the mechanism of action and properties of LactoSporin, the pH stability, thermostability, antimicrobial activity and 5-alpha reductase activity were evaluated in vitro. A significant improvement was observed in the dermatological assessment of closed comedones (p < 0.0001), open comedones (p = 0.0069) and papules count (p < 0.0001) in comparison to the baseline in both LactoSporin and benzoyl peroxide groups. The antera analysis showed significant improvement in redness (p < 0.0001) and elevation (p < 0.0001) (small and medium) in both the treatment groups. The sebumeter analysis showed a significant decrease in sebaceous secretion (p < 0.0001) for LactoSporin, which resulted in reduced oiliness, pimples, acne spots and redness around the acne spot. The product was found to be safe without any irritancy. LactoSporin was stable at an acidic pH and temperature range of 70 to 90 °C, with antimicrobial activity against various pathogenic bacteria, including Cutibacterium acnes. It was also a potent inhibitor of 5-alpha reductase activity. Thus, it can be concluded that the efficacy of LactoSporin is equivalent to benzoyl peroxide in the treatment of mild-to-moderate acne lesions and better than benzoyl peroxide for reducing the sebaceous secretion and oily, greasy nature of the skin, implying its efficacy in other sebohorriec conditions.

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Characterization of Weissella viridescens UCO-SMC3 as a Potential Probiotic for the Skin: Its Beneficial Role in the Pathogenesis of Acne Vulgaris

Microorganisms ◽

10.3390/microorganisms9071486 ◽

2021 ◽

Vol 9 (7) ◽

pp. 1486

Author(s):

Marcela Espinoza-Monje ◽

Jorge Campos ◽

Eduardo Alvarez Villamil ◽

Alonso Jerez ◽

Stefania Dentice Maidana ◽

...

Keyword(s):

Immune Response ◽

Oral Treatment ◽

Acne Vulgaris ◽

Topical Administration ◽

In Vivo Studies ◽

Mice Model ◽

Cutibacterium Acnes ◽

Snail Helix Aspersa

Previously, we isolated lactic acid bacteria from the slime of the garden snail Helix aspersa Müller and selected Weissella viridescens UCO-SMC3 because of its ability to inhibit in vitro the growth of the skin-associated pathogen Cutibacterium acnes. The present study aimed to characterize the antimicrobial and immunomodulatory properties of W. viridescens UCO-SMC3 and to demonstrate its beneficial effect in the treatment of acne vulgaris. Our in vitro studies showed that the UCO-SMC3 strain resists adverse gastrointestinal conditions, inhibits the growth of clinical isolates of C. acnes, and reduces the adhesion of the pathogen to keratinocytes. Furthermore, in vivo studies in a mice model of C. acnes infection demonstrated that W. viridescens UCO-SMC3 beneficially modulates the immune response against the skin pathogen. Both the oral and topical administration of the UCO-SCM3 strain was capable of reducing the replication of C. acnes in skin lesions and beneficially modulating the inflammatory response. Of note, orally administered W. viridescens UCO-SMC3 induced more remarkable changes in the immune response to C. acnes than the topical treatment. However, the topical administration of W. viridescens UCO-SMC3 was more efficient than the oral treatment to reduce pathogen bacterial loads in the skin, and effects probably related to its ability to inhibit and antagonize the adhesion of C. acnes. Furthermore, a pilot study in acne volunteers demonstrated the capacity of a facial cream containing the UCO-SMC3 strain to reduce acne lesions. The results presented here encourage further mechanistic and clinical investigations to characterize W. viridescens UCO-SMC3 as a probiotic for acne vulgaris treatment.

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Pro-Inflammatory and Neurotrophic Factor Responses of Cells Derived from Degenerative Human Intervertebral Discs to the Opportunistic Pathogen Cutibacterium acnes

International Journal of Molecular Sciences ◽

10.3390/ijms22052347 ◽

2021 ◽

Vol 22 (5) ◽

pp. 2347

Author(s):

Manu N. Capoor ◽

Anna Konieczna ◽

Andrew McDowell ◽

Filip Ruzicka ◽

Martin Smrcka ◽

...

Keyword(s):

Neurotrophic Factor ◽

Acne Vulgaris ◽

Opportunistic Pathogen ◽

Intervertebral Discs ◽

Disc Disease ◽

Gene Target ◽

Cutibacterium Acnes ◽

Pre Treatment

Previously, we proposed the hypothesis that similarities in the inflammatory response observed in acne vulgaris and degenerative disc disease (DDD), especially the central role of interleukin (IL)-1β, may be further evidence of the role of the anaerobic bacterium Cutibacterium (previously Propionibacterium) acnes in the underlying aetiology of disc degeneration. To investigate this, we examined the upregulation of IL-1β, and other known IL-1β-induced inflammatory markers and neurotrophic factors, from nucleus-pulposus-derived disc cells infected in vitro with C. acnes for up to 48 h. Upon infection, significant upregulation of IL-1β, alongside IL-6, IL-8, chemokine (C-C motif) ligand 3 (CCL3), chemokine (C-C motif) ligand 4 (CCL4), nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF), was observed with cells isolated from the degenerative discs of eight patients versus non-infected controls. Expression levels did, however, depend on gene target, multiplicity and period of infection and, notably, donor response. Pre-treatment of cells with clindamycin prior to infection significantly reduced the production of pro-inflammatory mediators. This study confirms that C. acnes can stimulate the expression of IL-1β and other host molecules previously associated with pathological changes in disc tissue, including neo-innervation. While still controversial, the role of C. acnes in DDD remains biologically credible, and its ability to cause disease likely reflects a combination of factors, particularly individualised response to infection.

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A New Antibiotic-Loaded Sol-Gel Can Prevent Bacterial Prosthetic Joint Infection: From in vitro Studies to an in vivo Model

Frontiers in Microbiology ◽

10.3389/fmicb.2019.02935 ◽

2020 ◽

Vol 10 ◽

Cited By ~ 4

Author(s):

John Jairo Aguilera-Correa ◽

Amaya Garcia-Casas ◽

Aranzazu Mediero ◽

David Romera ◽

Francisca Mulero ◽

...

Keyword(s):

Prosthetic Joint Infection ◽

Joint Infection ◽

Sol Gel ◽

In Vitro Studies ◽

In Vivo Model ◽

Prosthetic Joint

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Association of Antimicrobial Susceptibility and Treatment Outcome in Acne Vulgaris Patients: A Pilot Study

Journal of Laboratory Physicians ◽

10.1055/s-0040-1720943 ◽

2020 ◽

Vol 12 (04) ◽

pp. 233-238

Author(s):

Ashvini K. Yadav ◽

Suneel Bhooshan ◽

Allen Johnson ◽

Dinesh P. Asati ◽

Shashwati Nema ◽

...

Keyword(s):

Treatment Outcome ◽

Antimicrobial Susceptibility ◽

Acne Vulgaris ◽

Tertiary Care ◽

Care Hospital ◽

In Vitro Susceptibility ◽

Persistent Infections ◽

Significant Difference ◽

Cutibacterium Acnes

Abstract Purpose Cutibacterium acnes (C. acnes) is an emerging pathogen that is highly resistant to antibiotics and is capable of causing persistent infections that are difficult to treat. Methods & Materials Acne vulgaris patients visiting dermatology OPD of our tertiary care hospital during the study period of 2 months were recruited. Skin swabs were collected, and the sample was processed on 5% sheep-blood agar for anaerobic culture by the GasPak method. Isolates were identified by the standard biochemical test. Antimicrobial susceptibility testing was performed for clinically relevant antibiotics by the E-strip method. The clinical response was evaluated after 1-month follow-up to the prescribed antibiotics. Results Minocycline, doxycycline, ceftriaxone, and tetracycline were the most effective antibiotics. Nonsusceptibility to clindamycin and erythromycin were observed in 11.9% and 31% isolates, respectively, with 9.5% isolates being nonsusceptible to both. For none of the antibiotics we found significant difference in the proportion of susceptible and nonsusceptible isolates between mild, moderate, and severe grades of acne vulgaris. For none of the antibiotic regimens, significant difference was observed between nonresponders and responders. Twenty-seven patients received clindamycin and among them 16 of 19 responders and 6 of 8 nonresponders yielded growth of clindamycin-susceptible isolates (p = 0.57). Conclusion We observed significant prevalence of resistant strains of C. acnes among patients with acne vulgaris. No association was observed between in vitro susceptibility results and treatment outcome.

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ERYTHROSINE AS A PHOTOSENSITIZER FOR ANTIMICROBIAL PHOTODYNAMIC THERAPY WITH BLUE LIGHT-EMITTING DIODES – AN IN VITRO STUDY

Photodiagnosis and Photodynamic Therapy ◽

10.1016/j.pdpdt.2021.102445 ◽

2021 ◽

pp. 102445

Author(s):

Marcela Leticia Leal Gonçalves ◽

Elaine Marcílio Santos ◽

Ana Cláudia Muniz Renno ◽

Anna Carolina Ratto Tempestini Horliana ◽

Matheus de Almeida Cruz ◽

...

Keyword(s):

Photodynamic Therapy ◽

Blue Light ◽

Light Emitting Diodes ◽

In Vitro Study ◽

Vitro Study ◽

Antimicrobial Photodynamic Therapy ◽

Light Emitting

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Phage Activity Against Planktonic and Biofilm Staphylococcus aureus Periprosthetic Joint Infection Isolates

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.01879-21 ◽

2021 ◽

Author(s):

Katherine M. Caflisch ◽

Robin Patel

Keyword(s):

Staphylococcus Aureus ◽

Successful Treatment ◽

Periprosthetic Joint Infection ◽

Joint Infection ◽

Bacterial Isolates ◽

Small Colony Variant ◽

Small Colony ◽

Planktonic State ◽

Phage Activity

We recently reported the successful treatment of a case of periprosthetic joint infection (PJI) with phage. Phage activity against bacteria causing PJI has not been systematically evaluated. Here we examined the in vitro activity of seven lytic phages against 122 clinical isolates of Staphylococcus aureus recovered between April 1999 and February 2018 from subjects with PJI. Phages were assessed against planktonic and biofilm phenotypes. Activity of individual phages was demonstrated against up to 73% of bacterial isolates in the planktonic state and up to 100% of biofilms formed by isolates that were planktonically phage-susceptible. Susceptibility to phage was not correlated with small colony variant status. These results demonstrate that phages can infect S. aureus causing PJI in both planktonic and biofilm phenotypes, and thus are worthy of investigation as an alternative or addition to antibiotics in this setting.

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ALA-PDT Amplifies Intense Inflammatory Response in the Treatment of Acne Vulgaris via CXCL8

10.21203/rs.3.rs-127247/v1 ◽

2020 ◽

Author(s):

Lingling Zhang ◽

Jiayi Yang ◽

Xiaojing Liu ◽

Detian Xu ◽

Lei Shi ◽

...

Keyword(s):

T Cells ◽

Photodynamic Therapy ◽

Inflammatory Response ◽

Acne Vulgaris ◽

Specific Mechanism ◽

Lipid Secretion ◽

Severe Acne ◽

P38 Pathway

Abstract Background: Acne vulgaris is a chronic inflammatory cutaneous disease. 5-Aminolaevulinic acid photodynamic therapy (ALA-PDT) is a novel and effective therapy for severe acne vulgaris. However, the specific mechanism of ALA-PDT for acne still remain unclear. Here, we investigate the possible mechanism of intense inflammatory response of ALA-PDT for acne vulgaris. Results: It appeared that ALA-PDT suppresses proliferation and lipid secretion of primary human sebocytes. And ALA-PDT could up-regulate the expression of CXCL8 in vivo and in vitro, amplifying inflammatory response by recruiting T cells, B cells, neutrophils and macrophages. We also found that ALA-PDT elevated the expression of CXCL8 via p38 pathway. SB203580, a p38 pathway inhibitor, decreased the expression of CXCL8 after ALA-PDT in sebocytes. Conclusion: ALA-PDT amplifies intense inflammatory response in the treatment of acne vulgaris via CXCL8. Our data deciphers the mechanism of intense inflammatory response after ALA-PDT for acne vulgaris.

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Assessment of a Multiplex Serological Test for the Diagnosis of Prosthetic Joint Infection: a Prospective Multicentre Study

Journal of Bone and Joint Infection ◽

10.7150/jbji.42076 ◽

2020 ◽

Vol 5 (2) ◽

pp. 89-95 ◽

Cited By ~ 2

Author(s):

Pascale Bémer ◽

Céline Bourigault ◽

Anne Jolivet-Gougeon ◽

Chloé Plouzeau-Jayle ◽

Carole Lemarie ◽

...

Keyword(s):

Negative Predictive Value ◽

Predictive Value ◽

Serological Test ◽

Bacterial Species ◽

Joint Infection ◽

C Reactive Protein ◽

Reactive Protein ◽

Prosthetic Joint ◽

Prosthetic Joint Infections ◽

Cutibacterium Acnes

Abstract. Introduction: The diagnosis of prosthetic joint infections (PJIs) can be difficult in the chronic stage and is based on clinical and paraclinical evidence. A minimally invasive serological test against the main pathogens encountered during PJI would distinguish PJI from mechanical loosening.Methods: We performed a prospective, multicentre, cross-sectional study to assess the contribution of serology in the diagnosis of PJI. Over a 2-year period, all patients undergoing prosthesis revision were included in the study. A C-reactive protein assay and a serological test specifically designed against 5 bacterial species (Staphylococcus aureus, S. epidermidis, S. lugdunensis, Streptococcus agalactiae, Cutibacterium acnes) were performed preoperatively. Five samples per patient were taken intraoperatively during surgery. The diagnosis of PJI was based on clinical and bacteriological criteria according to guidelines.Results: Between November 2015 and November 2017, 115 patients were included, 49 for a chronic PJI and 66 for a mechanical problem. Among patients with PJI, a sinus tract was observed in 32.6% and a C-reactive protein level ≥10 mg/L in 74.5%. The PJI was monomicrobial in 43 cases (targeted staphylococci, 24; S. agalactiae, 1; C. acnes, 2; others, 16), and polymicrobial in 6 cases (12.2%). Sensitivity, specificity, positive predictive value and negative predictive value were 75.0%, 82.1%, 58.3% and 90.8%, respectively, for targeted staphylococci. Specificity/negative predictive value was 97.3%/100% for S. agalactiae and 83.8% /96.9% for C. acnes.Conclusions: The serological tests are insufficient to affirm the diagnosis of PJI for the targeted bacteria. Nevertheless, the excellent NPV may help clinicians to exclude PJI.

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